New research suggests that sexual minority women have an increased risk of unintended pregnancy compared to their heterosexual peers. Little research, however, has investigated the pathways that lead to these disparities, including sexual orientation disparities in contraception counseling and use. Sexual minority women may face several unique barriers to receiving adequate contraceptive counseling, including both decreased perceived risk for unintended pregnancy by both provider and patient, as well as increased stigma and discrimination in health care settings. Led by an interdisciplinary, mixed-methods team of researchers, this study will address existing gaps in the literature by identifying sexual orientation disparities in contraception use and counseling, assessing barriers to contraception use, and developing strategies to improve contraceptive care for this vulnerable population.